Essentials of Cardiopulmonary Physical Theraphy, ed 2. (Reviews).

Hillegass EA, Sadowsky HS, eds. Philadelphia, PA 19106, WB Saunders Co, 2001, hardcover, 885 pp, illus, ISBN: 0-7216-7288-4, $74.

This textbook is the second edition of a classic in cardiopulmonary physical therapy. It is intended for students and clinicians in the field as well as a reference for clinicians who do not routinely practice in cardiopulmonary areas. It is organized into 6 sections: "Anatomy and Physiology," "Pathophysiology," "Diagnostic Tests and Procedures," "Surgical Interventions, Monitoring, and Support," "Pharmacology," and "Cardiopulmonary Assessment and Intervention."

In the first section, the anatomy and physiology of both the cardiovascular and respiratory systems are described, with extensive illustrations and a logical organization.

Section 2 on pathophysiology has been extensively updated and reflects current findings, particularly regarding atherosclerotic disease and cardiac muscle dysfunction. The multisystemic nature of atherosclerosis is well described and highlighted, including renal vascular pathology, cerebral arterial disease, and peripheral vascular disease. Management of cardiac muscle dysfunction is well addressed, including recent findings regarding the use of resistance and inspiratory muscle training. In addition, new surgical interventions for severe heart failure, such as implanted ventricular assist devices and ventriculectomy, are addressed.

The chapter on restrictive lung disease is somewhat brief and has dated references; however, the overall presentation is good. Likewise, the chapter on chronic obstructive pulmonary diseases has not been significantly updated from the first edition, and it fails to address recent findings of skeletal muscle dysfunction in these diseases. This is somewhat disappointing, because these findings have important implications for exercise training. The last chapter in this section addresses the cardiopulmonary implications of a variety of systemic diseases, including renal failure, neurologic dysfunction, and rheumatologic conditions. It has been updated to reflect the current state of practice and is extensively referenced. The addition of case studies to this chapter greatly enhances it.

The third section, "Diagnostic Tests and Procedures," has been extensively revised for the second edition and addresses current practice in the field. The inclusion of tests for peripheral and carotid vascular disease is very helpful in highlighting the multisystemic nature of cardiovascular disease. Likewise, the addition of information regarding predicting mortality based on pulmonary function testing is in line with recent efforts to educate the public about smoking-related lung disease (ie, the "Know Your Numbers" campaign).

Section 4, "Surgical Interventions, Monitoring, and Support," has been extensively updated and revised from the first edition. It includes information about aneurysm repair, the use of gene therapy for coronary artery disease, and a new chapter about thoracic organ transplant. This information is exceptionally well presented and reflects very timely practice in this arena. The chapter on monitoring and life-support equipment includes many drawings and photographs that would be especially helpful for educators who are attempting to describe the intensive care unit environment to students.

The section on pharmacology is comprehensive, although it is less current in cardiovascular medications (chapter 14) than in pulmonary medications (chapter 15). The latter chapter even addresses the use of some herbal preparations for pulmonary diseases. This chapter is extremely well referenced.

Finally, section 6, "Cardiopulmonary Assessment and Intervention," includes a solidly written chapter on assessment and a completely revised chapter on acute interventions that seamlessly blends intensive care and acute hospital treatment and accurately reflects the role of the physical therapist in this dynamic arena. The chapter on cardiac rehabilitation and prevention illustrates the contemporary model of the role of exercise from an acute event through lifelong maintenance and also addresses the preventative nature of exercise. This chapter also includes valuable information about the management of a cardiovascular rehabilitation program that reflects recent changes in reimbursement, the use of resistance exercise, and adapting programs for special populations. The chapter on pulmonary rehabilitation is somewhat disappointing, because it has not been significantly updated and it fails to address current issues such as the role of resistance training in this population. The section concludes with a new chapter on outcome measures that adds great value to the text. The majority of tools used to measure outcomes in cardiopulmonary physical therapy are addressed, and readers are given guidance about their application to specific situations through very helpful case studies.

All sections have been updated to reflect changes in the medical field as well as changes in physical therapy, such as incorporation of the Guide to Physical Therapist Practice. A new feature of this edition is the inclusion of "Clinical Notes" throughout each chapter, which highlight the importance of information discussed to physical therapy management. All chapters have case studies with a helpful discussion at the end.

The writing throughout this text is clear and well organized. The editors have ensured a consistent theme from all guest authors. The contributors include many of the best-known names in the field of cardiopulmonary physical therapy and reflect the diversity of care and practice settings, from acute hospital to community-based wellness and education. Illustrations are used extensively, including both drawings and photographs. Case studies at the end of each chapter provide a good illustration of how to apply the information to physical therapy practice. The glossary is extensive and very helpful.

This edition is an up-to-date version of a standard, classic textbook in the field and will be of great value to physical therapy students, educators, and clinicians as well as those preparing for clinical specialization in cardiopulmonary physical therapy.

Anne K Swisher PT, CCS
West Virginia University
Morgantown, WVa

Ms Swisher is Assistant Professor in the Division of Physical Therapy and teaches in the area of cardiopulmonary physical therapy and exercise physiology. She also conducts research on pulmonary disease and muscle dysfunction and is a Cardiopulmonary Clinical Specialist practicing in the areas of cystic fibrosis and chronic heart failure.